I have been on 75mcg for a number of years since having a lobectomy and isthmusectomy in 2015. This was reduced from 100mcg in 2019 following TFT (TSH 0.02) even though I felt well on this dose. I have been feeling very fatigued and achy for a while and had a blood test by the GP in January 2023 for which ‘no action’ was required. I almost felt that my symptoms were ignored.
Serum vitamin B12 level 385 ng/L [190.0 - 883.0]
Serum ferritin level 99 ug/L [30.0 - 200.0]
Serum folate level 7.3 ug/L 3.1 - 20.0]
In July 2023 as part of my annual review TSH was measured at 0.54 miu /L [0.35-4.84] but this was after taking Levothyroxine in the morning on the day of test.
I am determined to get to the bottom of my fatigue as it isn’t me and is really starting to get me down. So, I have had the Medicheck test above which will be forwarded to my GP before my telephone consultation on Wednesday.
Any comments and advice will be gratefully received.
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SpringerMom
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GP's can be very dismissing of non specific fatigue like symptoms, not least because they don't know what to do to help.
Your B vitamins aren't looking good at all so they will be making you feel terrible alone. I'll come back to that.
Free T4 (fT4) 15.2 pmol/L (12 - 22) 32.0%
Free T3 (fT3) 4.4 pmol/L (3.1 - 6.8) 35.1%
Your TSH is above 1 and most people need it at or below 1 to feel well.
Your FT4 is not even at 50% and on Levo alone would likely need to be at 80%+ to have enough to convert to active T3.
Basically you need a dose raise. Many GPs are happy to keep patients just within the normal range and are scared of giving too much hormone so are therefore conservative and keep people on too little hormone.
Try asking for a trial increase which can seem more appealing to GPs. Stand your ground and if the first GP says no then try a different one at the same practice. Some are more open minded than others.
B12 - do you have symptoms of B12 deficiency? The reference range for B12 is very wide and cut off point too low. theb12society.com/signs-and...
If you do then you should discuss this with your doctor for further tests for Pernicious Anaemia.
If not, then start with a methyl B12 sublingual spray or lozenge for a week, then add a good B complex. Once you run out of the separate B12 just continue with the B complex.
Vitamin D should be around 100 - 150. Buy one that includes vit K2 to help it go to your bones. Some are available in oil or you can take it with an oily meal for better absorption. Many members like the ‘Better You’ range of mouth sprays that contain both bit D & K2. Use this calculator to work out how much to take to get your level to 100-150. wildatlantichealth.com/vita...
Wow, thank you Jaydee. I have many symptoms of Pernicious Anaemia from the link so will mention this to the GP along with request of a dose change. I now feel much more informed to get to the bottom of this.
In July 2023 as part of my annual review TSH was measured at 0.54 miu /L [0.35-4.84] but this was after taking Levothyroxine in the morning on the day of test.
Taking your levo on the day of the test will not affect your TSH. It doesn't move that quickly. It just affects the FT4, but if they didn't test that, it doesn't matter.
It's the time of day that affects the TSH. It's highest before 9 am, and lowest around midday. So, what time was the blood draw?
I am determined to get to the bottom of my fatigue
Look no further. Your FT3 is low, your FT4 is low - in-range but low - your vit D, folate and B12 are all low. Not surprising you're tired.
Thank you Greygoose. My July NHS blood test was at 9.45am and latest Medicheck was at 7.30am. I’m so glad that I began investigating this myself as I’ve had enough of feeling rubbish.
Would you suggest requesting an increase from 75mcg to 100 or higher and then peg back if necessary? Will an increase in Levo also help to increase B12? TIA
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